Still home...

...thankfully, but little boy isn't feeling very well at all. It seems to be bacterial overgrowth in his gut and we are changing a medicine today in hopes that it will help and our sweet little guy will again feel like playing, talking and having a good time. We took him for labs yesterday and his numbers are holding steady, not great but steady enough to stay home.

Because John isn't gaining weight we will be experimenting with several bacterial overgrowth options in the near future, for the moment though we have to get past the current issues. Bacterial Overgrowth can among other things cause lack of weight gain, weight loss and even if left unchecked can starve a person to death while they are eating all the time.

In the normal persons system the stomach is kept sterile by the acid present, the small intestine has no bacteria of it's own in it, the ileocecal valve keeps things flowing from the small intestine to the large and not backwards, and the large intestine is filled with bacteria, mostly beneficial. Short gut kids have anatomical issues that cause the normal bacterial routine to be difficult at best. Since John has no ileocecal valve between his small and large intestines the bacteria are free to flow from his colon into his small intestine and he most likely has bacteria all the way up to the pyloric valve, the valve between the stomach and small intestine. His gut also flows differently than normal because it is very distended and even with good peristalsis things don't flow efficiently. This allows the bad bacteria a place to grow and do bad things like break down food in ways that the body can't absorb, or just steal the nutrients from the food and also to choke out the beneficial bacteria that break down food in a way that the body can utilize.

John has been taking flagyl and neomyacin, two antibiotics, in a 7-10 day rotation for a long time. Interestingly enough these actually kill the good bacteria also, but they increase the oxygen level in the gut at the same time with also kills the bad bacteria indirectly. We have been told by John's docs that he may always have to have some antibiotic help to maintain a workable bacterial balance in his gut. There are some natural things to try and we will be working with those as time goes on.

Probiotics, introducing beneficial bacteria to the gut, is all the rage right now, and even though the data on it isn't ironclad there is evidence that while not a cure-all it will certainly be helpful. So we will be doing that in one form or another. Probiotics are found in yogurt that has live cultures and can also be found in a powdered form too. John was on the powdered form a long time ago with some good affect and had been on yogurt for a while but that habit fell to the wayside on vacation and he's lost the taste for it. One of the doctors who talked to us about this gave us some valuable information on yogurt that the extra price for Activa and such are just advertising gimmicks and that all live-culture yogurt contain the same bacteria, that's what makes it yogurt, as opposed to it being buttermilk, or cheese, both of which also are made with bacteria.

Prebiotics is pretty much the new kid on the block, that is giving the gut the food that the bacteria (probiotics) need to live on. The easiest of these to do is Metamucil which is a soluble fiber. Unlike all the commercials that we see about Metamucil helping with constipation, which give the impression that the fiber itself does something, you need insoluble fiber for that effect, the soluble fiber of Metamucil is one of the favorite foods of the good gut bacteria and can not only help them increase but can help them help the colon absorb another 500+ calories per day. This is another area without ironclad proof but then there is a certain degree of art in all medical science so ironclad proof is not assured even in the best things. One study that we read though stated that while probiotics will increase the beneficial gut bugs 'x' amount, no I don't remember the exact number, what I do remember is that in that study it was found that prebiotics will increase the beneficial gut bugs '10x' and that the combination is higher still. So we will be doing that too, as the current crisis situation settles down.

When we were at St. Louis Children's this time the GI fellow that was on duty was taking the time to visit with us about these gut issues, he is doing his research on gut bacteria, we're thrilled to know that he's doing that and to have the chance to talk to him too. It is so nice to have access to such learned people so that we can learn more about why John has problems and what we can do to help him. Here's hoping that John doesn't have to be hospitalized again anytime soon, we know that it is part of his life that we will always deal with, but still it's nice to be home.